Author:Eberechukwu Uneze,Ibrahim Tajudeen&Ola Iweala

Publication Date:September, 2011

Document Size: 42pages

This report presents a Cost-Effectiveness analysis of water interventions in Bauchi state,Nigeria, with particular emphasis on pipeline and borehole (Hand pump) water supply schemes.Using the measures adapted from Whittington et al (2008), this study estimates the cost andeffectiveness measures such as time savings and health benefit aimed at reducing the incidenceof and death from, diarrhea disease. First, it conducts a BASIC CEA which compares the cost perhousehold per year of PWS with BWS program. Second, it performs a PROGRAM CEA todetermine the relative effectiveness of the programs. The cost analysis shows that BWS is lessexpensive than PWS. Combining cost and effectiveness, the cost-effectiveness ratio shows theBWS is more cost-effective than the PWS program.

Nevertheless, CEA is not sufficient to determine the most attractive intervention, since itcannot quantify cost and effectiveness in the same unit. Hence, a benefit-cost analysis, whichestimates the monetary value of benefits, is applied. The results of the BCA seem to supportthe evidence that emerged from the cost-effectiveness analysis.

A sensitivity analysis is then performed to determine the robustness of these findings. A onewayand multi-way sensitivity analyses (with worse and best case scenarios) performed on theresults show that BWS is more cost-effective and attractive. The study then concludes with arecommendation that in areas where there are high cases of morbidity/mortality fromdiarrheal, access to portable water and improved health outcomes in densely populated areascan be achieved by diverting resources from BWS to PWS, that is by increasing pipeline watersupply. The converse is true for sparsely populated areas with low cases of morbidity/mortalityfrom diarrheal. However, in mildly populated areas with moderate cases ofmorbidity/mortality, PWS and BWS can be implemented as complements.